ABSTRACT
Objective: To distinguish normative fears from problematic fears and phobias. Methods: We investigated 2,512 children and adolescents from a large community school-based study, the High Risk Study for Psychiatric Disorders. Parent reports of 18 fears and psychiatric diagnosis were investigated. We used two analytical approaches: confirmatory factor analysis (CFA)/item response theory (IRT) and nonparametric receiver operating characteristic (ROC) curve. Results: According to IRT and ROC analyses, social fears are more likely to indicate problems and phobias than specific fears. Most specific fears were normative when mild; all specific fears indicate problems when pervasive. In addition, the situational fear of toilets and people who look unusual were highly indicative of specific phobia. Among social fears, those not restricted to performance and fear of writing in front of others indicate problems when mild. All social fears indicate problems and are highly indicative of social phobia when pervasive. Conclusion: These preliminary findings provide guidance for clinicians and researchers to determine the boundaries that separate normative fears from problem indicators in children and adolescents, and indicate a differential severity threshold for specific and social fears.
Subject(s)
Humans , Male , Female , Child , Adolescent , Phobic Disorders/diagnosis , Fear/psychology , Phobic Disorders/classification , Phobic Disorders/etiology , Psychiatric Status Rating Scales , Psychometrics , Reference Standards , Social Environment , Severity of Illness Index , Surveys and Questionnaires , Risk Factors , ROC Curve , Factor Analysis, StatisticalABSTRACT
OBJETIVOS: Este estudo tem por objetivo investigar a presença de fobia específica (FE) entre pacientes atendidos em um ambulatório de psiquiatria. MÉTODOS: Foi realizado um estudo transversal, no qual foi aplicado o SCID-I em 103 pacientes, para se examinar a ocorrência de fobia específica. Os dados foram analisados por meio de medidas descritivas e mediante os testes de independência baseados na estatística qui-quadrado de Pearson ou no teste exato de Fisher. RESULTADOS: Foi verificada FE em 26,2 por cento dos pacientes. As mulheres tinham duas vezes maior chance de apresentar FE que os homens. Em 96,3 por cento do total de fóbicos, a FE não havia sido identificada pelo psiquiatra com quem se consultavam, e esses pacientes não estavam recebendo tratamento para FE. Entre as comorbidades, o diagnóstico mais freqüente foi depressão, que apareceu em 15,6 por cento da amostra. No total, identificamos 39 fobias, sendo 13 do tipo animal; 12 do tipo ambiente-natural; 3 do tipo sangue-injeção-ferimentos; e 11 do tipo situacional. CONCLUSÃO: A FE tem uma freqüência elevada entre pacientes ambulatoriais, sendo mais comum entre as mulheres. No entanto, na maioria das vezes, esse transtorno não é diagnosticado e assim não recebe tratamento adequado, já que o foco da atenção fica concentrado nas comorbidades.
OBJECTIVES: The study was designed to investigate the presence of specific phobias (SP) among psychiatric outpatients. METHODS: A transversal study was carried out in which SCID-I was applied to 103 patients to determine the occurrence of specific phobia. The data were reviewed through descriptive measures and independence tests based on Pearson's chi-square test or Fisher's exact test. RESULTS: Specific phobias were found in 26.2 percent of the patients. Females were twice as likely as males to present SP. In 96.3 percent of the phobic patients SP had not been diagnosed by their psychiatrists and thus was not being treated. The most common comorbidities among these patients was depression, which was present in 15.6 percent of the sample. Overall, 39 different phobias were identified: 13 of the animal type, 12 of the natural environment type, 3 of the blood-injection-injury type, and 11 of the situational type. CONCLUSIONS: SP has a high frequency among outpatients and is more common among women. Most of the times, however, this disorder is not diagnosed and thus is not properly treated, as the focus remains on the comorbidities.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Ambulatory Care , Cross-Sectional Studies , Phobic Disorders/diagnosis , Anxiety/classification , Anxiety/diagnosis , Comorbidity , Phobic Disorders/classification , Phobic Disorders/epidemiologyABSTRACT
Sao descritos os principais instrumentos para avaliacao de fobias: os inventarios de medo, as escalas gerais e para agorafobia, fobia social e fobias especificas. Enfase e dada na necessidade da avaliacao multidimensional, tanto dos aspectos cognitivos quanto fisiologicos, comportamentais e de incapacitacao
Subject(s)
Humans , Psychiatric Status Rating Scales , Evaluation Study , Phobic Disorders/classification , Anxiety/classification , Psychometrics , Agoraphobia/classification , Fear/classification , Phobic Disorders/diagnosisABSTRACT
Os autores conceituam transtornos de esquiva fóbica, sua classificaçäo e sistematizam os princípios teóricos dos tratamentos cognitivo-comportamentais. É enfatizado o papel da exposiçäo aos estímulos eliciadores de ansiedade no tratamento.
Subject(s)
Humans , Animals , Phobic Disorders , Behavior Therapy , Phobic Disorders/classification , Phobic Disorders/therapyABSTRACT
Um perfil clinico da fobia social e descrito neste artigo, bem como seu tratamento farmacologico e psicologico